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Mastectomy: Indications, types, and concurrent axillary lymph node management

Authors
Ava Kwong, MBBS, BSc, FRCS, FCSHK, FHKAM
Michael S Sabel, MD
Section Editor
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Deputy Editor
Wenliang Chen, MD, PhD

INTRODUCTION

A mastectomy, defined as the complete removal of the breast tissue, is a surgical option for patients diagnosed with breast cancer as well as a prophylaxis to reduce the risk of breast cancer in high-risk women.

This topic will address the types and indications for a mastectomy, management of the axilla for patients undergoing a mastectomy, and the techniques and complications of mastectomy. Breast conservation therapy for breast cancer and the surgical management of regional lymph nodes in breast cancer patients are reviewed separately. (See "Breast conserving therapy" and "Management of the regional lymph nodes in breast cancer".)

SURGICAL ANATOMY

The surgeon must understand the complex anatomy of the chest wall and axilla in order to ensure removal of all breast tissue with preservation of maximum muscular function and sensation (figure 1 and figure 2 and figure 3). Axillary anatomy and the techniques of sentinel node biopsy and axillary dissection are discussed elsewhere. (See "Sentinel lymph node biopsy in breast cancer: Techniques" and "Technique of axillary lymph node dissection".)

SELECTION CRITERIA FOR MASTECTOMY

Mastectomy is indicated for patients who are not candidates for breast conserving therapy, patients who prefer mastectomy [1], and for prophylactic purposes to reduce the risk of breast cancer.

Breast conservation is contraindicated or unsuccessful — The criteria that preclude breast conservation are presented here briefly and addressed in detail elsewhere. (See "Breast conserving therapy", section on 'Patient selection for BCT'.)

                                        

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Literature review current through: Nov 2016. | This topic last updated: Wed Jan 13 00:00:00 GMT+00:00 2016.
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